Responsible for performing telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports
Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team
Manages members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits
Obtains a thorough and accurate member history to develop an individual care plan
Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs
The RN has overall responsibility to develop the care plan for services for the member and ensures the member's access to those services

Requires an RN and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role
Current, unrestricted RN license in applicable state(s) required
MA/MS in Health/Nursing preferred
May require state-specified certification based on state law and/or contract
Bilingual in Spanish, Bengali, Urdu, Punjabi, Korean, Creole highly preferred
Prior UAS Experience Preferred

LTSS Service Coordinator – Community RN

Key skills